Not many in Sawarkhed village of Nanded’s
Mahoor taluka smile
or laugh unreservedly. When interacting with a stranger, they are mindful of their
mouths. “It is embarrassing,” says Rameshwar Jadhav. As he speaks, you can see
that all his teeth are rotten and misshapen, their colours ranging from yellow ochre
to dark brown.

Ramaeshwar, 22, an agricultural
labourer, is not the only one with this problem in Sawarkhed, a village of
around 500 people. Almost every adult’s teeth here have deteriorated in varying
degrees. Many also have a limp or are permanently hunched over as they slowly
make their way through the narrow alleys and green fields. Those who can walk,
need frequent breaks. The entire village appears to move in slow motion in a
different era.

This tableau has been created by
what’s inside the earth, beneath the feet of the villagers: the groundwater
here contains fluoride. This is a chemical that is naturally present in
soil, rocks and groundwater. But in
concentrated form, it can be extremely harmful. According to the World Health Organisation, more than 1.5 mg of fluoride per
litre of water is dangerous for consumption. In Sawarkhed, it was 9.5 mg when
the Groundwater Surveys and Development Agency (GSDA) checked the fluoride
level around 2012-13.

“The formation of flourosis
depends on the extent of flouride in water, and therefore its progression
varies," says Dr. Ashish Ardhapurkar, a physician based in Nanded town. Once the deterioration sets in, he says, it
cannot be reversed. "But children are protected from it. They become
vulnerable to dental flourosis only after they develop wisdom teeth, and to
skeletal flourosis after their bone growth, which mostly happens after the age
of six."

PHOTO •
Parth M.N.

PHOTO •
Parth M.N.

Rameshwar Jadhav (left) and his father Sheshrao are among many in Sawarkhed affected by the high levels of fluoride in their drinking water

“Fluorosis can be checked in the initial
stages,” says Satish Berajdar, a well-known dentist in Latur town. “If not, the
effects are far-reaching. People are permanently handicapped, their teeth are destroyed.
It reduces the body’s immunity and overall ability to cope as well, and makes
you vulnerable to other diseases.”

But the people of Sawarkhed didn’t know this
for a long time. They kept consuming the
contaminated water until 2006, when the state provided a tap at a dug well. That
well is around one kilometre away, and even today is not sufficient for the
drinking needs of the entire village. Whereas handpumps on borewells are at
nearly every doorstep. “We knew the water we drank [from handpumps] was not the
purest. But nobody told us it was so dangerous. And when you are desperate for
water, you have to consume what you get,” says Madhukar Jadhav, a 55-year-old
farmer and agricultural labourer.

By the time awareness started creeping in, it
was too late for Madhukar’s sister Anushaya Rathod (in the cover photo on top). “It started with pain in the knees [some 30 years
ago],” she says, her teeth all gone. “The pain then spread across the body. Eventually,
the shape and size of my bones changed, reducing me to a cripple.”

When the pain in the
joints began, the family did not imagine it was due to the water they were
drinking. "We thought it was an ordinary illness," Madhukar says.
"Later, when it became alarming, we took her to many doctors in Yavatmal,
Nanded and Kinwat. I must have spent over one lakh rupees, borrowing most of it
from relatives and friends. But no treatment worked and I did not have the
capacity to spend more. Eventually, we gave up…”

According to the Ministry of Drinking Water and Sanitation, as many as 2,086 water sources in Maharashtra have fluoride, along with nitrate and arsenic – both highly harmful too

Watch video: Fluorosis-hit farmers describe their difficulties

Anushaya, now in her 50s, cannot stand on her feet anymore. She can
hardly move around, and has to use her hands because her bony legs remain
folded into each other. This has been her condition for over 10 years. “I have
become a burden on my family,” she says. “I live with my brother, he looks
after me. But I feel guilty I cannot do anything for him and his family.”

Madhukar has seen his own productivity
fall over the years. “If I work for an hour on the farm, I have to take a break
of half an hour. My back aches a lot,” he says. “It is a task to even attend to
nature’s call. The body is so inflexible.” Madhukar cultivates cotton, tur and
jowar
on his six acres. He also works as an agricultural labourer. “Nobody pays me
the amount that labourers usually get [around Rs. 250 a day]. It is saddening
to see your worth go down.”

Pankaj Mahale’s family too tried various treatments, but he lost his 50-year-old
father six years ago. "He had skeletal flourosis," Pankaj, 34, says.
"He was bent from the waist. We took him to bone specialists, to doctors
in Nanded and even Nagpur. But they said my father's bones have become so brittle
that even a minor jerk could break him down. They gave him calcium medicines
that cost 3,000 rupees per month. To take him to doctors in various places, we
had to hire a private car. The expenses ran into lakhs by the time he died. The
district administration did not offer any free medical help."

PHOTO •
Parth M.N.

Many in these villages of Marathwada, afflicted by skeletal fluorosis, limp or have misshapen bones

So where did the excessive flouride in Sawarkhed’s water come from? Drought is at the core
of the flourosis in this region. For several decades, the farmers here
have been drilling borewells to extract groundwater for irrigation, washing and
bathing. But with water shortages growing in increasingly arid Marathwada in
the last two decades, they started drinking the groundwater too. Flouride exists in some groundwater sources,
but the deeper a borewell is dug, the more the chances of the flouride content
increasing. Additionally, fertilisers,
pesticides, sewage, industrial effluents and depletion in groundwater led to
higher concentrations of flouride.

Although a borewell must
not go deeper than 200 feet (according to the
Maharashtra Groundwater Act of 2009) , borewells in Marathwada are frequently as deep as
500 feet or more. Without any monitoring of the number and depth of borewells,
and with water requirements increasing due to erratic rainfall and a shift to cash
crops, farmers in this region
desperately drill deeper until they find some water.

And if a village is unlucky to have sunk a borewell where the fluoride content is high, as Sawarkhed was, the chemical slowly seeps into the people – so much so that 209 of Sawarkhed’s 517 residents are now categorised as “non-workers” by Census 2011. And a report of the National Programme for the Prevention and Control of Flourosis notes that (till 2013) 3,710 persons in Nanded had dental fluorosis, and 389 had skeletal flourosis.

Local
journalist Dharmaraj Hallyale, who has followed this crisis closely, says even after tap water was made available in Sawarkhed in
2006, for four years the tap did not function properly. “There would be no
electricity,” he says. “So the pump wouldn’t work. I wrote to the district
collector and the state government. I followed it up for a month, before it was
eventually fixed in 2010.” Hallyale also filed an RTI (Right to Information) application
seeking information for the entire state – and 25 districts [out of a total of
36] turned out to have fluoride in their water sources in varying degrees.

PHOTO •
Parth M.N.

Sukesh Dhavale of Sunegaon (Sangvi) village has got dental fluorosis after drinking fluoride-infused water

These numbers vary depending on the source of the
data. According to the Ministry of Drinking Water and Sanitation, in the year
2016-17, as many as 2,086 water sources in Maharashtra had fluoride, along
with nitrate and arsenic – both highly harmful too. The number has apparently
decreased over the years – in 2012-13, it was 4,520. In Nanded district,
according to an affidavit filed by the collector in August 2014 at the National
Green Tribunal (NGT), water sources in 383 villages had flouride over
permissible limits, of which 257 were provided alternative sources of water. In 2015-16
though, the GSDA categorised 46 villages in Nanded as flourosis-affected, and claimed that merely four of those remain to be tackled.

On
January 11, 2016, following an
application by a team of nine advocates led by Asim Sarode about villagers
being forced to drink flouride water, the NGT ordered the collectors of 12
districts in Maharashtra along with the
GSDA to, among other measures, monitor water quality and publish district-wise
information; provide alternative water sources; and provide medical facilities
to patients free of cost. When this was ignored, on November 28, 2017 the NGT
issued warrants against the 12 district collectors, including those of Nanded,
Chandrapur, Beed, Yavatmal, Latur, Washim, Parbhani, Hingoli, Jalna and Jalgaon.

Meanwhile, Sunegaon (Sangvi) village, around 200 kilometres from Sawarkhed, now has a dug well, which did not exist before. After the Limboti dam was constructed around 2006, a lake formed near the village of 630 residents in Latur’s Ahmadpur taluka. This enhanced percolation, and when they dug a well in 2007, they hit water.

But by then Sukesh Dhavale, 30, had consumed fluoride-infused groundwater for 20 years, and seen his health deteriorate like the people in Sawarkhed. “I constantly feel there is a layer on my teeth,” says the agricultural labourer, getting up from under a tree, his joints audibly creaking. “The layer falls off after a while. But so does a part of the tooth. I cannot eat anything hard. My joints also hurt, I cannot work for long.”

At the Ahmadpur laboratory of the GSDA, around eight kilometres from Sunegaon (Sangvi), the person in charge searches on a computer, at our request, for a list of fluorosis-prone villages; an adjacent village, Sunegaon Shendri, is on the list of 25 such villages in Latur district. Govind Kale, 35, of Sunegaon Shendri, who is with me, exclaims, “We have been drinking groundwater for a year now. The common [dug] well in the village is not working. The entire village drinks borewell water. Why is anybody not doing anything about it? Why are we not warned in advance?”

Eighty years after this problem was first highlighted in Andhra Pradesh’s Nalgonda village (now in Telangana) – even a documentary titled Crippled lives was made on this – no lessons seem to have been learnt.